Laserfiche WebLink
<br />PERMITTEE NAME: <br />PERMIT NO.: <br />OPERATION NAME: <br />ANNIVERSARY DATE <br />ANNUAL FEE DUE: <br />COUNTY: <br />Mathias Concrete, Inc. <br />M-1980-201 <br />O'Bannon Pit <br />October 23, 2003 <br />$688.00 (Due on or before your anniversary date) <br />12io Grande <br />RECEr~E® <br />ocr~s~ <br />Division al Minerals and GeoloBY <br />According to C.R.S. 34-32.5-116 or C.R.S. 34-32-116, each year, on the anniversary date of the permit, an operator <br />shall submit the annual fee, a report and map showing the extent of current disturbances to affected land, <br />reclamation accomplished to date and during the nreceSlitl~y~ar, n~w_distUrbances_tbat_a[e_anticipated_to_ncs~ur <br />during the upcoming year, reclamation that will be performed during the coming year, the dates for the beginning <br />of active operations, and the date active operations ceased for the year, if any. <br />Please attach your revised written anneal re,Fnrf and anneal rennrt man to this form. Please note that an <br />adequately labeled map that clearly delineates and includes the above elements may suffice for a written report. <br />Division records indicate the following permittee contact information. Please verify and make any necessary <br />changes: <br />Permittee Contact: Thomas G. Mathias <br />Permittee Name: Mathias Concrete, Inc. <br />Address: 1500 N. Farm Rd. <br />P.O. Box 266 <br />Phone Number: <br />Fax Number: <br />Monte Vista, CO 81144 <br />(719) 852-3732 <br />(719) 852-3759 <br />c/ <br />~, <br /> <br />If you have additional comments and/or information that should be provided to the Division, please provide it <br />below or attach it to this form along with your written report and map. Annual Report instructions are enclosed. <br />M:~PERMITMASTERD000M ENTSU1-Ar-0 I <br />